Corticosteroids for dengue infection

Abstract

Dengue is a disease caused by a virus transmitted by mosquitoes,
occurring in many resource-limited countries, and children are often
most severely affected. Most infected patients will recover with mild
symptoms, but a few progress to severe dengue and may die. There is no
specific treatment for dengue, but some clinicians provide
corticosteroids at an early stage to prevent progression to severe
dengue disease; and some treat patients with dengue-related shock with
corticosteroids to improve survival. It is important to summarise the
effects of corticosteroids in dengue.

We conducted a search up to 6 January 2014 and included eight studies
which enrolled 948 participants in total. Four studies of
corticosteroids in the treatment of dengue-related shock assessed if
corticosteroids could improve survival, but these studies were small and
older than 20 years. The evidence we found is of very low quality and do
not provide any reliable evidence for corticosteroids for treating
dengue-related shock. Four trials evaluated whether corticosteroids
provided at an early stage of dengue could prevent development of
complications of severe dengue. These trials were more recent, but data
were insufficient to be sure whether corticosteroids have an effect on
the course of the disease.